Most Social Security Disability claims are resolved long before they reach the federal district courts. While more than half of the SSD claims filed are initially denied, most claimants who appeal their denial to the next level are successful and are awarded benefits. That success comes after an administrative law judge (ALJ) conducts a hearing at which you and your advocate or lawyer draw the judge’s attention to the details of your case that justify a finding of disability.
If your claim is denied after the ALJ hearing, and that denial is upheld by the Social Security Disability Appeals Council, then it may be time to appeal the denial of your claim to federal court.
Appealing the SSD Denial to the United States District Court
Before a claim gets to the federal district court level, it is always advisable to have your case handled by a qualified, experienced Social Security Disability attorney. But if you are taking the case to federal court on appeal, only a lawyer can represent you. The District Court appeal process involves arguments about technical legal principles and statutory provisions. Non-lawyer advocates are not legally permitted to represent claimants outside of the administrative process.
Winning in Federal Court
The federal court does not hear the case from the beginning. Once the claimant’s lawyer files the appeal, the Social Security Administration files its answer along with the transcript of the hearing and the supporting materials. The U.S. District Court reviews everything and considers the arguments and briefs submitted by the lawyers.
The judge examines whether there is “substantial evidence” to support the finding of the ALJ who conducted the hearing and whether the hearing judge made any errors in assessing the testimony or the medical records. If the U.S. District Court judge determines that the ALJ overlooked some significant fact or neglected to include specific findings to support their conclusions, then the federal judge can remand the case, meaning they send it back to the Social Security Administration to be reconsidered.
Top Winning Arguments in Federal Court Appeals
Each of the conclusions made by the hearing judge in their written denial decision needs to be made according to regulations that apply to every case. The goal is to have every case assessed by the same standard. The task of the U.S. District Court judge handling the appeal is to ensure that each of these legal standards was applied accurately and appropriately in your case.
Your SSD attorney analyzes every word in the ALJ’s decision and highlights every instance in which a rule or a regulation was misapplied or was wrongly decided by the hearing judge.
These are arguments that convinced most U.S. District Court judges to overturn the ALJ’s decision denying benefits between 2010 and 2020:
1). Discounting a treating physician’s medical opinions without explaining the evidence; If the ALJ seems to give less weight to a doctor’s opinion, the ALJ must specify why they did so. The hearing judge is not allowed to arbitrarily accept one opinion and not another. They are required to state why they favor one opinion over another when they write the decision.
2). Discounting the claimant’s testimony about their symptoms without a specific explanation; In some cases, the ALJ who conducts a hearing expresses doubts about the symptoms the claimant testifies to during the hearing. If they have substantial evidence to support their conclusions, they must identify them in the written decision. In the absence of an adequate explanation, the U.S. District Court judge can remand the case for rehearing.
3). Failing to identify or discuss one of the claimant’s treatment providers; The ALJ is required to address all the evidence presented in the claimant’s case in the written decision. If one of the treating physician’s records or opinions is ignored without comment, the federal court can send the case back for reconsideration.
4). Failing to adequately explain their rationale for giving a consulting doctor’s opinion more weight;
5). During the process of a Social Security Disability claim, an independent consulting physician may be asked to provide an opinion about the condition of the claimant. If the ALJ gives the consulting doctor’s opinion more weight than that of the claimant’s own doctors, then the ALJ must explain what substantial evidence supports that decision.
6). Failing to adequately evaluate a claimant’s mental limitations in deciding the residual functional capacity of the claimant (RFC); Disability can be based on physical or mental impairments or a combination of both. Where a federal judge finds the ALJ underestimated the degree to which a mental impairment limited the claimant’s overall residual functional capacity, the case can be remanded.
7). Failing to adequately develop the record or developing it incorrectly, or incompletely; The ALJ’s written decision denying benefits must spell out the evidence on which they based their conclusion. If it doesn’t, the case can be remanded.
8). Incorrectly finding an impairment “Not Severe”. A severe impairment is defined as one that significantly limits a claimant’s ability to do basic work activities required to perform most jobs. If the record supports a finding that an impairment is severe, but the ALJ denied benefits, the federal judge will remand the case.
Appealing your SSD benefits denial to the US District Court requires the legal expertise of an experienced Social Security Disability lawyer. Don’t settle for anything less than the best.